He was fortunate enough to be hired as an assistant cameraman on Blackmail (1929), the first British talkie, directed by a young Alfred Hitchcock. Neame's own career as a cinematographer began with the musical comedy Happy (1933), and he continued to develop his skills in various "quota quickies" films for several years.

Neame made his directorial debut under the Cineguild banner, with Take My Life, which was released by British producer J. Arthur Rank'sGeneral Film Distributors in the United Kingdom in 1947 and by Rank's Eagle-Lion Films in the United States in 1949.[7] Neame began a transition to the American film industry at the suggestion of Rank, who asked him to study the Hollywood production system.[8]

He worked again with Alec Guinness (whom he had worked with on Great Expectations and Oliver Twist), this time as director, in three films: The Card (1952), The Horse's Mouth (1958), and Tunes of Glory (1960). Neame has described Tunes of Glory as "the film I am proudest of".[5] He received two BAFTA Award nominations for Tunes of Glory. Neame and Guinness worked again in the 1970 musical Scrooge with Guinness playing the ghost of Jacob Marley to Albert Finney's Ebenezer Scrooge.

Neame was recruited to direct The Poseidon Adventure (1972) after the contracted director left the production. He later characterised The Poseidon Adventure as "my favourite film" because it earned him enough to retire comfortably.[5] He enjoyed a long friendship with Walter Matthau, whom he directed in two later films, Hopscotch (1980) and First Monday in October (1981).

In 1996, Neame was appointed a Commander of the Order of the British Empire (CBE) and awarded the BAFTA Fellowship for his contributions to the film industry. He had homes in Beverly Hills and Santa Barbara, California. In 2003, Neame published an autobiography, Straight from the Horse's Mouth. (ISBN 978-0810844902)

Neame married Beryl Heanly in 1933. They legally separated in 1971 and divorced in 1992. The couple had one son, Christopher, a writer/producer. Sadly, Christopher died exactly one year after Ronald's death. Ronald's only grandson, Gareth Neame, is a successful television producer, who represents the fourth generation of Neames in the film industry. Ronnie Neame's second marriage took place in Santa Barbara on 12 September 1993. His wife, Donna Bernice Friedberg, is also in the business – a film researcher and television producer, who worked on his 1979 movie Meteor. He referred to their meeting as a "coup de foudre".

Neame died on 16 June 2010 after suffering complications from a broken leg.[2] The break required two surgical procedures from which Neame never recovered.[9]

In an interview in 2006, he jokingly stated, "When people ask me about the secret to my longevity, I say the honest answer is two large vodkas at lunchtime and three large scotches in the evening. All my doctors have said to me, 'Ronnie, if you would drink less, you'd live a lot longer.' But, they're all dead, and I'm still here at 95."[10]

Neame is survived by his wife, Donna Neame, and his three grandchildren, Gareth, Shuna and Emma.